能量多普勒超声定量评估滋肾育胎丸改善PCOS卵泡发育及卵巢血流作用的研究

发布时间：2018-05-10 11:38

  本文选题：三维能量多普勒超声 + 多囊卵巢综合征　； 参考：《广州中医药大学》2017年硕士论文

【摘要】：目的:1.运用三维能量多普勒超声观察卵巢血流和卵泡发育情况,定量评估滋肾育胎丸对PCOS患者卵泡发育及卵巢血流灌注的调节作用。2.通过对比治疗前后各参数的变化,探讨滋肾育胎丸具有改善PCOS患者卵泡发育及卵巢血流灌注的临床疗效,为滋肾育胎丸在临床上的推广应用提供更确切、直接的影像学依据。方法:1.27名PCOS患者及20名月经正常的健康妇女进行经阴道三维能量多普勒超声检查,记录卵巢体积(OV)、卵巢数目(FN)及卵巢间质动脉血流参数(VI、FI、VFI),结合实验室性激素水平的检查,分析比较两组各参数的差异。2.在前期研究的基础上,采取自身前后对照的研究方法,给予纳入研究的27例PCOS患者滋肾育胎丸治疗6个月经周期,并运用三维能量多普超声观察治疗前后各指标的变化,评估疗效。结果:1.治疗前PCOS组与正常组结果分析1.1二维超声特征:PCOS组卵巢体积、卵泡数显著高于正常对照组,而最大卵泡直径则小于正常组,差异有显著统计学意义(P0.01)。1.2卵巢间质动脉三维能量多普勒超声血流参数:VI、VFI在PCOS组显著高于正常组,差异有统计学意义(P＜0.05);两组间FI无明显差异性(P0.05)。1.3性激素水平:PCOS组血清LH、PRL、T水平以及LH/FSH比值显著高于正常组,差异有显著统计学意义(P＜0.0001,P=0.002,P=0.001,P0.05)。两组血清FSH、E2.P水平无明显差异(P＞0.05)。1.4各参数间的相关性:PCOS组卵巢内卵泡数与LH、LH/FSH比值呈正相关(r=0.631,r=0.543,P0.05),正常组与LH、LH/FSH无显著相关(r=0.123,r=0.102,P0.05)。PCOS 组 VI、VFI 与 LH、LH/FSH 水平均呈正相关(r=0.884,r =0.711;r=0.919,r=0.639,P0.05),正常组则与其无显著相关(r=0.745,r=0.696;r=0.115,r=0.039,P0.05)。2.治疗后PCOS组自身前后对照2.1二维超声改变:治疗后PCOS组卵巢体积缩小,卵泡数减少,可见增大卵泡。PCOS组治疗后OV、FN均低于治疗前,最大卵泡直径明显大于治疗前,差异有统计学意义(P0.05)。2.2血流参数变化:治疗后PCOS组患者卵巢间质动脉V1、VFI值较治疗前均显著降低,差异有显著统计学意义(P0.01);治疗前后FI无明显变化,差异无统计学意义(P0.05)。2.3性激素水平方面:治疗后PCOS组血清LH、PRL、T水平及1H/FSH低于治疗前,差异有统计学意义(P＜0.05)。治疗前后血FSH、E2、P水平无显著差异(P0.05)。结论:1.三维能量多普勒超声可通过获取PC0S患者卵巢血流参数VI、FI、VFI,定量评估卵巢及卵泡周围微血管密度及血流灌注情况,可应用于滋肾育胎丸治疗PCOS的疗效评估。2.血清LH、LH/FSH、T、PRL等激素水平是影响卵巢及卵泡血流灌注的重要因素,与卵巢血流参数VI、FI、VFI存在一定的相关性。3.滋肾育胎丸能改善肾虚型PC0S患者的内分泌环境,通过降低血清LH、LH/FSH、T、PRL水平,改善卵巢及卵泡周围血流灌注,有助于促进卵巢排卵功能的恢复。
[Abstract]:Purpose 1. Three-dimensional power Doppler ultrasound was used to observe the ovarian blood flow and follicle development, and to evaluate quantitatively the regulating effect of Zishen Yueye pill on follicular development and ovarian blood perfusion in PCOS patients. By comparing the changes of parameters before and after treatment, we discussed the clinical effect of Zishenyufeiwan on improving follicular development and ovarian blood perfusion in patients with PCOS, and provided a more accurate and direct imaging basis for the clinical application of Zishenyufeiwan. Methods Twenty one hundred and twenty-seven patients with PCOS and 20 healthy women with normal menstruation were examined by transvaginal three-dimensional power Doppler ultrasonography. The ovarian volume and the number of ovaries were recorded. Analysis and comparison of the differences between the two groups of parameters. On the basis of previous study, 27 cases of PCOS patients were treated with Zishen Yuet pill for 6 menstrual cycles, and the changes of indexes before and after treatment were observed by using three dimensional energy Doppler ultrasound. To evaluate the curative effect. The result is 1: 1. Analysis of the results before treatment in PCOS group and normal group 1.1Ovarian volume and follicle number were significantly higher and the maximum follicle diameter was smaller in the ratio of two dimensional ultrasound than that in the normal control group, but the diameter of the largest follicle was smaller than that in the normal group. There was significant difference in blood flow parameters of three dimensional power Doppler ultrasound in the interstitial artery of ovary (P 0.01). 1.2. The blood flow parameters of VIVFI in the PCOS group were significantly higher than those in the normal group. There was no significant difference in fi between the two groups (P < 0.05), and the serum LHH PRLT level and the LH/FSH ratio in the two groups were significantly higher than those in the normal group (P < 0.0001, P < 0.002, P < 0.002) and the ratio of LH/FSH was significantly higher than that in the normal control group (P < 0.0001, P < 0.002, P < 0.002) and the ratio of LH/FSH was significantly higher than that in the normal group (P < 0.05). 涓ょ粍琛，

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